Article from Telehealth.org
By: Julia Ivanova, PhD, MA
Takeaways
- The Senate passed the continuing resolution (CR) on November 10, 2025, and the President signed it on November 12, 2025, ending the 42-day shutdown and extending key Medicare telehealth flexibilities.
- Flexibilities that continue under the CR include home as the originating site for non-behavioral care, audio-only Medicare visits, expanded providers, and federally qualified health center (FQHC)/ rural health center (RHC) distant-site status.
- With the legal lapse bridged, Medicare Administrative Contractors (MACs) are expected to resume and pay retroactively for claims impacted by telehealth services provided on or after October 1, 2025. Practices should watch for further CMS/MAC guidance.
- The in-person requirement for behavioral telehealth visits for Medicare beneficiaries is delayed until January 30, 2026.
Government Shutdown Ends With Passage of H.R. 5371
The government shutdown has ended. After the Senate passed the package on November 10, 2025 (60–40), the House cleared the measure and sent it to the President, who signed the Continuing Resolution (H.R. 5371) into law on November 12, 2025, reopening the government and extending select flexibilities.
Key Medicare Telehealth Flexibilities Extended Through January 2026
The continuing resolution (CR) extends Medicare telehealth flexibilities, which were previously extended by the Consolidated Appropriations Act of 2023, through January 30, 2026. The following flexibilities are now extended:
- Home as the originating site and no geographic restrictions for Medicare non-behavioral telehealth visits
- Federally Qualified Health Centers and Rural Health Centers as distant-site providers
- Audio-only non-behavioral telehealth visits
- Telehealth meets the face-to-face recertification requirements for hospice care
- Expanded provider eligibility for general telehealth (i.e., occupational therapists, physical therapists, speech-language pathologists, and audiologists)
- The Acute Hospital Care at Home program
- Delayed in-person visit requirements for behavioral telehealth visits
As shown above, with the CR’s new end date, the behavioral health in-person visit requirement timeline aligns with the extension window. Any clarification or additional guidance from the Centers for Medicare and Medicaid Services (CMS) will be included in our follow-up coverage.
Retroactive Medicare Claim Payments Expected
Though there is no specific wording, as previously mentioned, the writing of the CR intends to ensure retroactive payment for Medicare claims. Taken together with the CR’s new January 30, 2026 date, the affected Medicare telehealth flexibilities are now treated, in legal effect, as continuing through the lapse, which supports retroactive claims processing.
News coverage and telehealth advocates, such as ATA Action, have already reported that Medicare telehealth claims since October 1 will be processed and paid retroactively. We therefore expect Medicare Administrative Contractors (MACs) to begin releasing and reprocessing the impacted telehealth claims. We will provide updates again as the CMS issues any further operational instructions.
What Clinicians Should Do Now
If you have Medicare telehealth claims dated October 1, 2025, or later, you can prepare to submit them under the restored authorities. Continue to watch MLN Connects for code-level or batching instructions.
Looking Ahead: Building Stability for Telehealth in 2026
This shutdown has underscored that the “telehealth cliff” is a genuine concern, disrupting clinicians, patients, and organizations. We look to proposed legislation, such as the CONNECT for Health Act and the Telehealth Modernization Act of 2025, for more consistency in how telehealth policy is handled. Until those individual bills are passed through Congress, telehealth stakeholders will need to continue planning how their practices will adapt to these short-term extensions of telehealth flexibilities.
